diff --git a/app/views/freecyclery/receipt.html.haml b/app/views/freecyclery/receipt.html.haml
index 1441828..086a690 100644
--- a/app/views/freecyclery/receipt.html.haml
+++ b/app/views/freecyclery/receipt.html.haml
@@ -3,8 +3,6 @@
     .receipt
       %h2
         %strong= @client.bike.name
-        %br
-        = 'Log Number: ' + @client.bike.log_number.to_s
       %br
         .horizontal-line
         .client-information
@@ -13,8 +11,6 @@
         = @client.agency.agency_name if @client.agency
         .horizontal-line
         %br
-        = 'Paid $25 for lock and helmet' if @client.will_pay
-        %br
         Includes:
         %br
         = 'Helmet' if @client.helmet
@@ -40,8 +36,6 @@
     .receipt
       %h2
         %strong= @client.bike.name
-        %br
-        = 'Log Number: ' + @client.bike.log_number.to_s
       %br
         .horizontal-line
         .client-information
@@ -49,27 +43,33 @@
         %br
         = @client.agency.agency_name if @client.agency
         .horizontal-line
-        %br
-        = 'Paid $25 for lock and helmet' if @client.will_pay
-        %br
-        Includes:
-        %br
-        = 'Helmet' if @client.helmet
-        %br
-        = 'Lock' if @client.lock
-        %br
-        %br
-        Date Received
-        %br
-        _______________
-        %br
-        Client Signature
-        %br
-        ________________
-        %br
-        Recyclery Volunteer Initials
-        %br
-        ___
-        %br
-        RECYCLERY COPY
-
+        .row
+          .col-xs-6
+            %br
+            = 'Will make 25$ payment for lock and helmet' if @client.will_pay
+            %br
+            Includes:
+            %br
+            = 'Helmet' if @client.helmet
+            %br
+            = 'Lock' if @client.lock
+            %br
+            %br
+            Date Received
+            %br
+            _______________
+            %br
+            Client Signature
+            %br
+            ________________
+          .col-xs-6
+            .client-info-header CLIENT INFO
+            .client-email= "Agency Email: " + @client.agency.email
+            .client-phone= "Agency Phone #: " + @client.agency.phone_number
+            .client-photo-consent [ ] I grant consent to the Recyclery to use and publish photographs of me.
+            %br
+            Recyclery Volunteer Initials
+            %br
+            ___
+            %br
+            RECYCLERY COPY
diff --git a/notes.txt b/notes.txt
index 62e69d3..d911eca 100644
--- a/notes.txt
+++ b/notes.txt
@@ -1,3 +1,5 @@
+change agency#phone_number to agency#phone
+
 on website, tailwind for tools initiative looks weird in carousel
 on mobile